| 1. |
- Feigin, Valery L., et al.
(författare)
-
Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
-
Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
-
Tidskriftsartikel (refereegranskat)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
|
|
| 2. |
- Sbarra, AN, et al.
(författare)
-
Mapping routine measles vaccination in low- and middle-income countries
- 2021
-
Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 589:7842, s. 415-
-
Tidskriftsartikel (refereegranskat)abstract
- The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.
|
|
| 3. |
- Callen, Michael, et al.
(författare)
-
COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries
- 2021
-
Ingår i: Nature Medicine. - : Springer Nature. - 1546-170X .- 1078-8956. ; 27:8, s. 1385-1394
-
Tidskriftsartikel (refereegranskat)abstract
- Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs. © 2021, The Author(s).
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Aiyelokun, Oluwatobi, et al.
(författare)
-
Credibility of design rainfall estimates for drainage infrastructures : extent of disregard in Nigeria and proposed framework for practice
- 2021
-
Ingår i: Natural Hazards. - : Springer Science and Business Media LLC. - 0921-030X .- 1573-0840. ; 109:2, s. 1557-1588
-
Tidskriftsartikel (refereegranskat)abstract
- Rainfall intensity or depth estimates are vital input for hydrologic and hydraulic models used in designing drainage infrastructures. Unfortunately, these estimates are susceptible to different sources of uncertainties including climate change, which could have high implications on the cost and design of hydraulic structures. This study adopts a systematic literature review to ascertain the disregard of credibility assessment of rainfall estimates in Nigeria. Thereafter, a simple framework for informing the practice of reliability check of rainfall estimates was proposed using freely available open-source tools and applied to the north central region of Nigeria. The study revealed through a synthesis matrix that in the last decade, both empirical and theoretical methods have been applied in predicting design rainfall intensities or depths for different frequencies across Nigeria, but none of the selected studies assessed the credibility of the design estimates. This study has established through the application of the proposed framework that drainage infrastructure designed in the study area using 100–1000-year return periods are more susceptible to error. And that the extent of the credibility of quantitative estimates of extreme rains leading to flooding is not equal for each variability indicator across a large spatial region. Hence, to optimize informed decision-making regarding flood risk reduction by risk assessor, variability and uncertainty of rainfall estimates should be assessed spatially to minimize erroneous deductions.
|
|
| 8. |
|
|
| 9. |
- Nasser, Abdullah B., et al.
(författare)
-
An Adaptive Opposition-based Learning Selection: The Case for Jaya Algorithm
- 2021
-
Ingår i: IEEE Access. - 2169-3536 .- 2169-3536. ; 9, s. 55581-55594
-
Tidskriftsartikel (refereegranskat)abstract
- Over the years, opposition-based Learning (OBL) technique has been proven to effectively enhance the convergence of meta-heuristic algorithms. The fact that OBL is able to give alternative candidate solutions in one or more opposite directions ensures good exploration and exploitation of the search space. In the last decade, many OBL techniques have been established in the literature including the Standard-OBL, General-OBL, Quasi Reflection-OBL, Centre-OBL and Optimal-OBL. Although proven useful, much existing adoption of OBL into meta-heuristic algorithms has been based on a single technique. If the search space contains many peaks with potentially many local optima, relying on a single OBL technique may not be sufficiently effective. In fact, if the peaks are close together, relying on a single OBL technique may not be able to prevent entrapment in local optima. Addressing this issue, assembling a sequence of OBL techniques into meta-heuristic algorithm can be useful to enhance the overall search performance. Based on a simple penalized and reward mechanism, the best performing OBL is rewarded to continue its execution in the next cycle, whilst poor performing one will miss cease its current turn. This paper presents a new adaptive approach of integrating more than one OBL techniques into Jaya Algorithm, termed OBL-JA. Unlike other adoptions of OBL which use one type of OBL, OBL-JA uses several OBLs and their selections will be based on each individual performance. Experimental results using the combinatorial testing problems as case study demonstrate that OBL-JA shows very competitive results against the existing works in term of the test suite size. The results also show that OBL-JA performs better than standard Jaya Algorithm in most of the tested cases due to its ability to adapt its behaviour based on the current performance feedback of the search process.
|
|
| 10. |
- Nichols, E, et al.
(författare)
-
Use of multidimensional item response theory methods for dementia prevalence prediction: an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study
- 2021
-
Ingår i: BMC medical informatics and decision making. - : Springer Science and Business Media LLC. - 1472-6947. ; 21:1, s. 241-
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundData sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally.MethodsUsing cognitive testing data and data on functional limitations from Wave A (2001–2003) of the ADAMS study (n = 744) and the 2000 wave of the HRS study (n = 6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we fit a logistic regression model for the classification of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex.ResultsOur algorithm had a cross-validated predictive accuracy of 88% (86–90), and an area under the curve of 0.97 (0.97–0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3–4) in individuals 70–79, 11% (9–12) in individuals 80–89 years old, and 28% (22–35) in those 90 and older.ConclusionsOur model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more flexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys.
|
|
